340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ADVENTIST HEALTH HOWARD MEMORIAL
CAH051310-01 Willits Hospital Inc., DBA Adventist Health Howard Memorial
Print
Covered Entity Details
Entity Name
Willits Hospital Inc., DBA Adventist Health Howard Memorial
Subdivision Name
Adventist Health Howard Memorial
Type
Critical Access Hospital
340B ID
CAH051310-01
Entity Address
3 Marcela Drive, Suite C
Willits, CA 95490-5769
Medicare Provider Number
051310
Outpatient Facility Provider Number
058680
Participating Start Date
10/1/2015
Last Recertification Date
8/18/2024
Pharmacy Details
Pharmacy Name
ADVENTIST HEALTH HOWARD MEMORIAL
Pharmacy Address
3 MARCELA DR STE B
WILLITS, CA 95490-5769
Pharmacy Comments
Contract Details
Approval Date
7/15/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Judson Howe, Network President
(707) 467-5352
Contract Pharmacy Representative
Adventist Health Ukiah Valley
Judson Howe, Network President
(707) 467-5352
Signed By Date
7/15/2020
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session